Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


UT Southwestern investigators perform head-to-head comparison of incontinence treatments

As part of a national clinical trial, UT Southwestern Medical Center researchers found little difference in effectiveness between two popular treatments for one of the most common ailments among American women: stress urinary incontinence.

Stress incontinence affects up to 50 percent of women in the U.S. at some point in their lives. Women with stress incontinence experience leakage during increases in abdominal pressure typically brought on by sneezing, coughing, lifting heavy objects or other types of physical activities.

UT Southwestern surgeons and colleagues at eight other sites compared the outcomes of two surgical procedures designed to alleviate symptoms of stress urinary incontinence. UT Southwestern was the only site in North Texas to participate in the trial.

The study, available online in the New England Journal of Medicine, shows that both surgical procedures – transvaginal sling (TVT) and transobturator midurethral sling (TOT) – appear to be similarly effective in women up to 12 months after the procedures were performed.

"Both procedures are done using minimally invasive techniques, but until now there haven't been any large prospective head-to-head randomized trials comparing the two popular techniques," said Dr. Gary Lemack, professor of urology and neurology and co-principal investigator at the UT Southwestern site.

The TVT sling, introduced in 1996, involves placing a thin strip of polypropylene mesh weave transvaginally and behind the urethra and pubic bone. The strip acts as a kind of scaffolding that supports the urethra, diminishing urine leakage.

The more recently developed TOT sling reduces the risk of bladder or bowel injury by passing the sling laterally into the groin through two small incisions in the upper thigh. This method works in the same way as the TVT, by supporting the urethra. Controversy exists as to which sling is more effective and which might be associated with a greater risk of complications.

"At one year, the two groups of patients were assessed both objectively and subjectively about the success of their procedures," said Dr. Lemack. "The outcomes appear very similar at one year regardless of the severity of the patient's stress incontinence symptoms."

Objective measures of success included testing whether or not there was any urine leakage with straining or coughing during an exam with a full bladder. Patients also were asked to wear a pad for 24 hours to determine if leakage occurred. Subjective self-reported criteria required patients to keep a three-day diary and record any symptoms of stress incontinence. They also reported the need for any further treatments.

"The rates of success using objective measures in patients with the transvaginal sling were around 81 percent, and 78 percent for patients who had the TOT procedure – equivalent by our preset criteria," Dr. Lemack said. "Rates of subjectively reported success were slightly higher in the transvaginal group and thus did not quite meet the criteria for equivalence."

Both procedures carry associated risks, albeit infrequently, and the key difference between procedures may be the rate of adverse events associated with each. For example, the TVT was associated with a greater likelihood of intraoperative bladder injury and postoperative voiding dysfunction, while the TOT was more likely to be associated with postoperative numbness and pain.

As a result, although the procedures are similar in effectiveness, Dr. Lemack says physicians could use the information gleaned from this study to more fully counsel patient about the risks and benefits of either operation.

Dr. Lemack said that future studies should help determine if any other parameters, such as bladder function studies, may help in predicting treatment success.

Other UT Southwestern faculty participating in the multi-center incontinence network included Dr. Philippe Zimmern, professor of urology; Dr. Joseph Schaffer, professor of obstetrics and gynecology; Dr. Marlene Corton, associate professor of obstetrics and gynecology; and Dr. Clifford Wai, associate professor of obstetrics and gynecology.

Funding for this study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases and by the National Institute of Child Health and Human Development.

Visit to learn more about UT Southwestern's clinical services in urology.

This news release is available on our World Wide Web home page at

To automatically receive news releases from UT Southwestern via e-mail, subscribe at

Katherine Morales | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg

nachricht New potential cancer treatment using microwaves to target deep tumors
12.10.2016 | University of Texas at Arlington

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

Im Focus: Ultra-thin ferroelectric material for next-generation electronics

'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.

Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Resolving the mystery of preeclampsia

21.10.2016 | Health and Medicine

Stanford researchers create new special-purpose computer that may someday save us billions

21.10.2016 | Information Technology

From ancient fossils to future cars

21.10.2016 | Materials Sciences

More VideoLinks >>>